Can injury from MRSA be caused by medical malpractice?

A: Our indiscriminate overuse of antibiotic medicine has given rise to a super-bacteria known as Methicillin-resistant Staphylococcus aureus (MRSA) that has developed immunity to many antibiotic treatments.

Now, doctors and healthcare providers must diagnose and treat infections that can turn deadly much faster than previously known bacterial infections. If MRSA is not accurately diagnosed or treated, it can quickly progress into flesh-eating infection, osteomyelitis or toxic shock death.

The following points represent a small sample of the ways that doctors, nurses and other healthcare providers can commit medical malpractice when dealing with MRSA.

1. Patients with prior MRSA infections and a history or recurrent infections of the soft tissues should be treated as if they are infected with MRSA until doctors are sure they are not. This is a “guilty until proven innocent” approach. MRSA is just too dangerous to treat this type of patient any differently. If these factors are present, they indicate that the patient is susceptible to MRSA. Since MRSA may advance more rapidly in already susceptible patients, all precautions should be taken. Such a patient should not be treated with cephalexin or other similar antibiotic. If a MRSA victim were treated initially with cephalexin, such a course only delays appropriate treatment and opens the door to the potential for unnecessary complications.

2. Normal infections can be treated with cephalexin. Such treatment is absolutely appropriate for non-MRSA infections. However, if a patient does not respond to that conservative treatment, doctors must either perform a culture or switch treatment to a MRSA-effective drug or take both steps simultaneously. Antibiotics that effectively combat MRSA are vancomycin, trimethoprim-sulfa, or linezolid. A failure to recognize a MRSA soft-tissue infection can cause the infection to progress past the point of treatment.

3. Failure to appropriately screen for pre-existing MRSA can lead to implant and wound infection. Experts now recommend that patients who receive medical hardware or prosthesis (including vascular grafts) should be checked before surgery for MRSA already living on the patient’s skin. MRSA on a person’s skin can be unproblematic. When MRSA moves from the skin into the body through a surgical incision, dangerous infections can arise. To prevent such infections, patients who are found to already have MRSA on their skin can either decolonize themselves or take MRSA effective antibiotics before surgery.

4. Once MRSA contaminates a patient’s blood, treatment must not be delayed. Several years ago, doctors thought bacteremia (blood infection) with Staphylococcus aureus was still considered a skin contaminant and not treated aggressively. A failure to recognize or treat MRSA blood stream infections can be deadly.

5. Doctors, nurses and healthcare providers know that deep infections require draining. IF a deep MRSA infection is not drained, the results can be devastating.

6. Even powerful antibiotics like vancomycin have limitations and side effects. Doctors’ failure to appreciate them can lead to a poor outcome in MRSA patients.

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